THIS PROTOCOL IS FOR RESEARCH PURPOSES ONLY, SEE PAGE 1 FOR USAGE POLICY AALL0232

4.9.2a DELAYED INTENSIFICATION I DOWN SYNDROME PTS _________________ ___________

ONLY Patient name or initials DOB
All patients receive common Delayed Intensification I therapy. Delayed Intensification I is
8 weeks (56 days). Leucovorin rescue will be given after each IT MTX.
Section 4.9 for therapy interruption
guidelines. This Therapy Delivery Map is on two (2) pages.

DRUG ROUTE DOSAGE DAYS IMPORTANT NOTES OBSERVATIONS

VinCRIStine (VCR) IV push over 1.5 mg/m2/dose Days 1, 8, 15, 43 & 50 + Or infusion via minibag as a. Hx, phys, wgt
1 minute+ per institutional policy b. CBC (diff/plts)
Maximum dose: 2 mg c. CSF! cell count,
Dexamethasone (DEX) PO 5 mg/m2/dose BID Days 1-7 & 15-21 10 mg/m2/day, divided BID. cytospin
(may give IV) See Section 4.9 for d. Bili, creatinine,
administration guidelines ALT
DOXOrubicin (DOXO) IV push 25 mg/m2/dose Days 1, 8 & 15 ! Obtain with each
PEG-asparaginase IM 2500 International Days 4 OR 5 OR 6 AND IT administration
(PEG-ASP) units/m2/dose Day 43
Cyclophosphamide IV over 30 min 1000 mg/m2/dose Day 29 See Section 4.9 for OBTAIN OTHER
(CPM) administration guidelines STUDIES AS
REQUIRED FOR
Cytarabine (ARAC) IV or SubQ 75 mg/m2/dose Days 29-32 & 36-39 GOOD PATIENT
Thioguanine (TG) PO 60 mg/m2/dose Days 29-42 See Section 4.9 for CARE
Omit all days for DS pts administration guidelines
receiving CRT
Intrathecal Methotrexate IT Age (yrs)Dose Days 1, 29 & 36 See Section 4.9 for
(IT MTX) 1-1.99 8 mg administration guidelines
2-2.99 10 mg Omit Day 36 IT MTX for
3-8.99 12 mg DS pts receiving CRT Note age-based dosing
15 mg
Leucovorin (LCV) PO 5 mg/m2/dose 48 & 60 hrs after each IT
MTX

Therapy Delivery Map Ht________cm Wt________kg BSA________m2

Date Date Day VCR DEX DOXO PEG-ASP IT MTX LCV Studies Comments
Due Given _____mg ____mg ____mg _____mg ______IU _____mg ____mg
Enter calculated dose above and actual dose administered below
1 _____mg ____mg ____mg _____mg ____mg a, b, c, d
2 ____mg ____mg
3 ____mg ____mg ____mg
4 ____mg ____mg ____mg
_____IU
5 ____mg ____mg
1 dose
6 ____mg ____mg
7 ____mg ____mg
8 _____mg _____mg b
---
15 _____mg ____mg ____mg _____mg b
16 ____mg ____mg
17 ____mg ____mg
18 ____mg ____mg
19 ____mg ____mg
20 ____mg ____mg
21 ____mg ____mg b
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